Tag Archives: Research

Why are adolescents that live in areas with high concentrations of tobacco shops more likely to smoke?

New findings suggest Scottish teenagers living in areas with a high density of shops selling tobacco have greater knowledge about cigarette brands.

Earlier work in Scotland found that adults and adolescents living in areas with high densities of shops selling tobacco were more likely to smoke. Public health researchers have suggested that restrictions on tobacco retail outlet density are a potential ‘new frontier’ in the long-running campaign to achieve a tobacco ‘endgame’. However, the reasons why exposure to greater numbers of tobacco outlets is associated with smoking are unclear and the types of restrictions on retail density that might best support this public health goal are not known.

A new study by CRESH has explored possible pathways linking tobacco outlet density to smoking among adolescents. Our work used responses from 22,049 13 and 15 year olds to the 2010 Scottish School Adolescent Lifestyle and Substance Use Survey. Data from the Scottish Tobacco Retailers Register were used to calculate a measure of the density of tobacco outlets around the survey respondents’ homes.

We were interested to know whether adolescents in areas with more tobacco outlets had better knowledge of tobacco products, and so assessed how many cigarette brands they could name. We also looked at whether adolescents in high outlet density areas had more positive attitudes about smoking as it has been suggested that exposure to outlets and the tobacco marketing and purchasing found within them may ‘normalise’ smoking. We examined whether in areas where there are more tobacco outlets it may be easier for adolescents to make underage cigarette purchases. Finally, we considered tobacco price, assessing whether in areas with more tobacco shops, and more retail competition, cigarettes were cheaper. Continue reading TOBACCO OUTLET DENSITY AND PATHWAYS TO SMOKING AMONG TEENAGERS→

In our latest paper published in Social Science and Medicine we critique the way ‘impact’ is measured within the UK’s Research Excellence Framework* (REF) and in doing so we propose an alternative measurement, one based on enlightenment and process rather than outcomes.

New research just published by CRESH in the European Journal of Public Health suggests there is a strong correlation between net migration, 2000-2010, and age- and sex- standardised death rates, 2008-2010 among the regions of Europe (Figure 1). The recent ‘migrant crisis’ in Europe has ensured that European political debate about migration, long centred on immigration, has continued to focus upon areas receiving migrants. This analysis suggests however that difficulties associated with immigration are the problems of advantage. Regions of Europe which experienced significant population growth through migration, were found mostly in Western countries with higher incomes and lower death rates. In contrast, Europe regions with net out-migration, predominantly located in the East, are burdened by the combined problems of low incomes, high death rates and population decline.

The 15th International Medical Geography Symposium, the biggest international academic health geography conference, took place July 7-12 this year, at Michigan State University (MSU) in East Lansing, USA. This conference is always a fun, friendly and inspirational meeting: a real CRESH highlight. This time we were represented by Helena Tunstall (presenting on ‘triple jeopardy’ in England and impacts of internal migration on health inequalities in UK), Anna Kenyon (presenting on walkability measures and walking outcomes in Scotland) and Catherine Tisch (presenting on tobacco environments and adolescent smoking behaviours in Scotland). Abstracts for these talks can be found in the program, but watch this space for news of forthcoming publications on these topics. In this short blog post we note some thoughts arising from the conference. Continue reading CRESH goes Stateside: International Medical Geography Symposium 2013→

A new piece of CRESH research has been published online in the journal Public Health this week. The paper “The role of physical activity in the relationship between urban green space and health” can be downloaded here. We looked at the health of over 8000 individuals who were interviewed for the New Zealand Health Survey in 2006 and 2007 and asked whether they were likely to be healthier if they lived in greener neighbourhoods. We found that residents of greener neighbourhoods did indeed have better cardiovascular and mental health, independently of their individual risk factors (e.g., sex, age, socioeconomic status). Green space might benefit health because it provides greater opportunities for physical activity, and we were able to test this hypothesis because the New Zealand Health Survey included information about how physically active each individual respondent typically was. We found that although physical activity was higher in greener neighbourhoods it did not fully explain the green space and health relationship. Therefore, other pathways between green space and health (e.g., social contacts, attention restoration) are likely to be equally/more important.

“Greenwash” is sometimes used to describe exaggerated or otherwise misleading claims made about a product or company’s environmental benefits. People are understandably becoming more and more cynical about environmental friendliness claims – but the danger is that genuine environmental benefits are rejected along with the greenwash, which “threatens the whole business rationale for becoming more environmentally friendly” (Futerra 2008).

I am concerned that the green space and health research agenda is at risk of being overtaken by a form of greenwash, as ironic as that may sound. Green spaces – also known as natural/vegetated/open spaces – clearly have some social, environmental and economic benefits. The research of CRESH and many other groups has demonstrated this. But these benefits are not experienced everywhere, or by everyone. The same wooded park may be a valued jogging or walking area for some people, but a terrifying no-go area for others. There is much important research to be done to understand and address the barriers that prevent different groups benefitting from green spaces. CRESH researchers are among many jointly trying to bridge this knowledge gap.

The greenwash that concerns me is the mantra that ‘green space is good’ – end of story. At a recent GreenHealth Conference (11th March 2013, Edinburgh) the fascinating results from a four-year Scottish Government funded research programme were presented. CRESH’s own Rich Mitchell presented on the topic “More green = better health?” and concluded that this is not always the case (see blog post). Nonetheless, in one of the afternoon discussions one attendee called for less research and more action “because we know green space is good already”. Additionally, some important Greenspace Scotland work – showing that investment in ten community green space projects across Scotland provides good social, environmental and economic value for money – has been misleadingly reported elsewhere as “Greenspace is good… fact!” This is greenwash. It is also an example of a factoid – an assumption or speculation that is reported and repeated until it is considered true (see Cummins and Macintyre’s 2002 paper on how “food deserts” made it into UK policy by such a pathway). Policy-making based on assumptions is dangerous: Cummins and Macintyre urge policy makers to look at the facts more critically.

Jane Jacobs – the influential American writer on urban planning – wrote about the greenwash surrounding green spaces (or ‘grass fetishes’ as she called it) more than 50 years ago. In The Death and Life of Great American Cities (1961, Random House, NY) she wrote that “In orthodox city planning, neighbourhood open spaces are venerated in an amazingly uncritical fashion…” (p.90). She qualifies that, while ”parks can and do add great attraction to neighbourhoods that people find attractive for a great variety of other uses”, they may also “exaggerate the dullness, the danger, the emptiness” (p.111). If the barriers to green space use are not identified and addressed local people cannot be expected to use and benefit from them, regardless of the intentions of well-meaning city planners. Informing people that ‘green space is good’ won’t help. The danger is that when their touted benefits don’t materialise, green spaces may fall out of favour, when in truth, and with greater attention to what the evidence tells us, they may have been a great public health resource. Instead of less research we urgently need to strengthen the evidence base and publicise our findings more widely. Watch this space.